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HomeMy WebLinkAbout96-00307 Eslare of -XAY.ElUA.._ -1l1l..cUlIS Z . also knowl/.,l1.f --.JLEf:l~~t., nr.}f'IIAC;Z t.,.... /ill/J MIII- dh [){ I ('{juS';: R~gist~r of Wills for the ti.dJ.-..t,,;"; tl/-7U9 >L-I.t:.H,/.i2._ Dw'asetl. Coulllyof CUMBERLAND Social Security No, 177 -20-7193 Commonweallh of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner~), who is/atK 18 years of age or older an the execuOR in the last will of the above decedent, dated I] /22L7A and codicil(s) dated EXt LV'~'r- .IJ..nlf".(f ill /~ 'Ill ,:'t'L"lJ (7)r PETITION FOI~ p(WnATE lIud GHANT OF LETTEHS No, _02 I - q lLJ - .3 0 7 To: in the named ,19_ /{Ji~~/9.f-; 4"t. ' <--- (Slate rclevanl circumstances, e,g. rcnunciillion, death of C'f;cculOr, ctc.) Decendent was domiciled at dealh in cmlBERLANO County, Pennsylvania. with hl'l'/ last family or principal rcsidence at f'IIMRI'IH.ANn f'I'/OC;C;TNr. I'/I''I'TI'/I'MI'N'I' CJ<NTER CARrISLE D^ 17n13' U.., '.\" Ill,'),'l, c" " . . {list street, number and muncipality} I Decendenl,then 75 years of age, died MARCH 4 ,1996 at CUMBERLAND CROSSING RET. CENTER , Except as follows, decedent did not marry, was not divorced and did not have a child born or adopled afler execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent al death owned property with cstimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa,) Personal property in Pennsylvania (If not domiciled in Pa,) Personal property in County Value of real estate in Pennsylvania situated as follows: 50 MATTIIF.t,,, AVF... NF.\, BRITAIN. BUCKS COUNTY $ 200,000.00 $ $ $ ]75,000.00 PA ]13901. WHEREFORE, petitioner(" respectfully request(s) Ihe probate of Ihe last will XlIlb(~~) presented herewith and the grant of letters TR:;TIW ImT ^ RY (testamentary; adminiswuion c.C.a.; .:Idmininralion d.b.n.C'.t.a.) theron. Ii :0& ~~ a,g 6~P nF.F.R RD ::Q ;~ ~nTr.TN~ ~P~TN~~ PA 17007 l>'_ .0 ;; = " Vi OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF C"MeJ<RI,~"D The pelitioner(s) above.named swear(s) or affirm(s) Ihat the slatemenrs in the foregoing petition arc true and correct 10 the best of the knowledge and belief u( peritioner(s) and Ihat as personal represen. lalive(s) of the above decedent petilioner(s) will weY-WI? }h~7 ad~~ the eslale according 10 law, Sworn 1,0 or affifll)~d and, S,"bSCrib cd {l-/K.-/:.' (J, - 1- ~ before me litis 10TH day of _ ~ 'I ' APR IL, 19 96_ ( g IJ..~,. I\. '/."("'--J ,.............. fl7~r ';~..~.~/ ::; '/ /' MARY C'. LF.I~IS R,'!:isl"" -r- i2: lOE - 96 - tG . fz1, :~ ,E-4 N tn e .~ ~ H f<< ~ 0 S ~ - ~ E-4 3 Recorood CliG(J of RO{JI!iIOr 01 Wills '96 APR 10 1\8 :16 Clark-!:",.\':,;""" Gourt Cumbciiono Co" PA , ~^ .~, '8"'" ,h::~~: ,Vl I!',... Gl , t:l :f~:c~:: ;Z; '", .,.,~ '.' ... ' ;c: ~~''':: 'c. ,.., ~ :>,';Zi' -Z"'_w,'o:,'Jt\, o.~' u. o,;,~ Vl 0 !ii5) Lll: 1:;.<'.'..,' :I:";c: .. '>-", ~; '.~:g:; . ~ ,.., ,.': ;;~ ~"",:~' ;;~f~;:i(l:}f , ':~';.<~:(:S/i:',: ... Q " "~i# , of' . . ~ . . MY LAST WILL AND TESTAMENT I, XAVERIA BLICHASZ, also known as VERA BLICHASZ of New Britain, Pennsylvania, declare this to be my Will and hereby "expressly revoke all prior Wills and Codicils and writings in the ;i 'nature thereof, heretofore made by me. ARTICLE 1 I declare that I am married to STANLEY BLICHASZ, and : that all references in this \~ill to "my husband" are references 'to him. I have two children of this marriage, now living, whose names are: CHARLES BLICHASZ, age 30 MARYANN BLICHASZ, age 27 I have no deceased children. All references in this Will to "my children" are references to the above children, as well as to any child hereafter born to or adopted by me and my husband. ARTICLE 2 I give and bequeath all of my jewelry, automobiles, books, i 'pictures, silverware, furniture and all other articles of personal: i and household use, equipment and ornament, together with the ins- :'urance policies thereon, to my husband, STANLEY BLICHASZ, if he , survives me by thirty (30) days. In the event my husband shall not 'so survive me, I bequeath said articles, together with the insurance policies thereon, to my issue who shall so survive me, per stirpes, the actual division of the property to be made as my issue may agree, or in the event of a dispute as my executor may, in his discretion, direct. My executor shall represent any minor beneficiary in making such selection. If any of the personalty bequeathed in this paragraph vests in a minor, I authorize my executor to deliver such personalty to the minor at such time or ~ . . . . . I times as my executor may deem advisable, in spite of the fact thati the legatee is a minor. and my executor may do so without lia- bility whatsoever for making such delivery, or my executor may deliver said personalty to the guardian of the minor or to the person with whom said minor resides, without bond. and receipt of said person shall be a complete discharge of all obligations of my executor with respect to said legacy to such minor. ARTICLE 3 I give, devise and bequeath the rest. residue and remainder of my estate to my husband, STANLEY BLICHASZ. if he survives me by thirty (30) days. If my husband does not so surviv~ me, I give the rest, residue and remainder of my estate to my issue who shall survive me, per stirpes. ARTICLE 4 I appoint my husband, STANLEY BLICHASZ. Executor of this my Will. In the event my husband, STANLEY BLICHASZ shall fail to qualify or ceases to act. I appoint my son. CHARLES BLICHASZ of North Plainfield, New Jersey, Executor of this my Will. I direct that my Executor and his successors shall not be required to enter bond or surety in any jurisdiction. ARTICLE 5 I authorize my executor to exercise the following powers~ I in addition to those given by law, in his sole discretion and witht out court approval: ! A. To retain any property which may at any time form a part of my estate, as long as it may be deemed advisable; - 2 - I \ I I I I C. To register sccuritics in thc name of a nominee in such I I I I D. To repair, alter, and improve or lease, for any periid time, any property; . II 'I I' II I' II II Ii q . . - . - B. To invest in any property without restriction to :\ legal investments; i i manner ~ \ that title shall pass on delivery; " \1 " I, of , , " , ii E. To sell at public or private sale for cash or credit If " Ii with or without security, to exchange or partition property and il !i to give options for sales or exchanges; I 1\ !i F. To borrow money from any person, including my II and to mortgage or pledge any property; :' . . execut r, I \ I i ! Ii G. To compromise claims; " I: d H. To make distributions in kind. " I: :\ :1 ARTICLE 6 I direct that all shares and interests in my estate, :,whether principa1.or income, while in the hands of my executor, " Ii Ii shall not be subject to attachment, execution, sequestration for any Ii debt, contract obligation or liability of any legatee or benefiCia~y, li ii and shall not be subject to pledge, assignment , conveyance, or il I' II anticipation. ,I Ii l: . .' ARTICLE 7 , :. i: I direct that all transfer, inheritance, legacy, estate ii :: and succession taxes, and all of the taxes in the nature thereof, " 1: whether State or Federal, and interest and penalties thereon, thatl ,. I may become due or payable by reason of my death, with respect to , 'I q the property compromising my gross estate for tax purposes, whether or not such property passes under this will, and including] jointly owned property and life insurance, shall be paid out of - 3 - - . . . . . - - the principal of my residuary estate, to the extent that there is such residuary available, as if such taxes were administration expenses without apportionment or right of reimbursement. I authorize my executor to pay all such taxes at such time or times, I as he may deem advisable, regardless of whether such taxes are then i due. ARTICLE 8 I appoint as Guardians for any property passing hereunder ! to a minor, and any share of insurance proceeds and other property with respect to which I have a power to appoint a Guardian, the parents of such minor or minors. If neither parent of such minor or minors is then living I appoint my oldest surviving child as Guardian for any property passing hereunder to such minor or minors, and any share of insurance proceeds and other property with respect to which I have a power to appoint a Guardian. Such Guardian shall have the administrative powers given hereunder to my executor and the additional powers without court approval, to use principal as well as income for the minor's welfare, to invest in any form of property without being limited to legal investments, and to retain or sell articles of tangible personalty or distribute them to the minor or any person to hold for the minor. I direct that the Guardian for the estate of a minor shall not be required to enter bond or surety in any jurisdiction. IN WITNESS \~EREOF, I, XAVERIA BLICHASZ, hereby set my of which has (vel V~'"" bt'_ )-- , hand to this my last Will ~nd ~estament, eac~page been initialled by me, on 1(/.tL"4li this 'Zz./k.. day of 1978, at Doy1estown, Pennsylvania. "V . I' 1 . _.L 'ht.<-n..-- /':)_tu~~ XAVERIA BLICHASZ ~ Signed, sealed, published and declared by XAVERIA BLICHASZ, the above-named Testatrix, as and for her last Will and Testament, .. . , - . in the presence of us, who, at her request, in her presence, and in the presence of each other, all being present at the same time, have subscribed our names as witnesses. c;~ -M c:;,5IJ~ of I .fJ.~~ --/~. 4)-"\ l'~rl'l f\'w\rlli!" V'~;~h, .Jy~ \,~ V<<. I of II 'I Ii . . ~. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: XAVERIA BLlCHASZ Date of Death: MARCH 4, 1996 Admin. No. 1996-00307 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above- captioned estate on May 13, 1996: CHARLES BLlCHASZ, 652 DEER RD, BOILING SPRINGS, PA 17007 MARYANN BLlCHASZ PURCELL, 106 CEDAR LANE, N BRITTAIN, PA 18901 Date: May 13, 1996 Signature: .: ;#$ Name: Robert D. Kodak Address: 407 N. Front SI. : PO Box 11848 : Harrisburg PA 17108 Telephone: (717)238-7151 Capacity: Counsel for Personal Representative 00 \Ci :r.l ~ F ~g 0' , ,-, =" :- :r> . "'" ~ 1...'1 '0 -; ,.,t N '" ):- ;... ~ Q. 0 V2 2 l /'1 ,. y RECEIVED BY It1)Ir~1 t. .' '''.1, ", I},f." " / $IG A1Ult , I '. (,. I /.,':q /IA. idl'i'7? MARY C. LEW'IS ,0 7,_ ,',- I' " - REGISTER OF WILLS . lI'#.U62 PI'.'" COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX '*' o NO. M 18491 B RECEIVED FROM: f3 ACN ASSESSMENT r;t CONTROL ... NUMBER AMOUNT CHARI.ES BLI CHi\SZ 652 DF.ER ROAD lul "'C:I,~I:>.c'f BOILING SPRINGS, F'A 17007 ESTATE INFORMATION, ~ filE NUMBER g 21-1'196-0307 ~ NAME Of DECEDENT ILAST) ~ DLfCHAS2 XAVERIA II DATE Of PAY:ENT EJ POSTMARK E COUNTY SSN 177-20-7193 IfIRST) (Mil CUMBERLAND DATE Of DEATH fa TOTAL AMOUNT PAID $21.515.29 REMARKS CHARLES 5 DLICH"S~ SEAL CHECK" 121 REGISTER OF WILLS . - .........~......"..- ~. ~.-bo:l.~_ _'-'" "'"'I". AO. H Line 191, greor.r than line 18. ent.r ,ho differ.""o on Lin. 20. This illhe OVERPAYMENT. aD 21. If lino 18 i, 9reater than una 19, enter the difference on Litle 21. This illho TAX DUE. A. 2nlerlh. l"'or.,. on the ba!ancI dill on line 21A. B. Entor the tolal of Line 21 Clnd 21A ol'llinl 218. Th:, is 1110 BALANCE DUE. Mak. eh.... Pa obi. la. R.gl".. al Will.. Ag.nt . .~. " '":'~:,,,.,,:,;"': ,:~,~;;eE'5URE TO ANSWER ALL QUESTIONS ON REVERSE SlDE'ANll,TOREeHECI< MATH '<'<~,,:':' ,,.,......,,, 'j,:':' Under patlal,;.s o' pllrtury, I dedorll thaI I 1'10." ..ominlld Ihit ''''wrn, includi"9 o((omponrin9 ,chodulo. and UOIO"'(lnl., and 10 th. be,t af"'7 knowl"dgll Clnd belief. II is Iruo. carro" and compl,no. I d8~a'" 1~C1t all ,uell oUolo hos been re~onea at INO :narkDI "OII,iCl. Oac!arolion or proparor ather thon the pel'lol'lol ,epr.lflflfCllj.,e i, bClsod en all infertTlalia" of ....hich pr"~a'''' hen any ~nawlndg" IiIG~" L or '\~){,lf'f ~u~:a~u, PlUNG .tfulf'ol ~Cil.ru. . :IAt( / J (': J:it',,- 'lc'l... (r, 1 (),o,;,:/c:,.,II~<,.l~. (.~''''~" PIlle) n1(j19t. ATIoIU 0' '1("AlU on,.:_ ,,,"I'ol _(PIO( '^,.y' ...(.Il.1ilLU IJAlt ~l\\j IUV.IS~ Ix. 17"~1 ~ M:!w ...... ....~.. ... 9 .. . .. .. '!i ::l~ "'co "'z co.. ". .. S! :c - '::> C .. .. .. ... ... '" S ~ II( ~ E '" co .. ~ ~ , ! . '\ t3P,'1 DEe 03 '56 03: 37F~1 "NUPP ~ ,\ ' \ , "OD.~" PC /1, if. .z 1\ , ( . ( J . rOA DATIS or DIATH AmA 12/~1191 CHECK HERE IF A SPOUSAL POVIRrY ClIO" IS eLAIMID 0 FlU NUMBER 21-1996-307 COUNTY CODf INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) NUMB!R (OM.MONW[AUH 0' 'FNNUt'-'..NIA Qt'An""l O' l['[NUI QI/T lIOCIOI HAUISlutO, ,.. '"21'(;~ gUJ,UUd'lI HAlIlt ,,,,,,,,. JlIII....,.,.O .IlIlOOlllNlflAq nAR UI.I.hII.Nn c..UM'~1.1I. AOlI.IILU !i ~ .. '" to! .. BLICU^SZ X~VBRIA .oclaL "CVlllfY NUN'tI CUMBERLAND CROSSING RETIREMENT CENTER, CARLISLE PA 17013 c."" llERLAl:lD aMOuNt Ill'L1Vl.U IUI. INsnu'IICl'dl 11Sl1. Original R'Mo o A, Umi,.d ElIo'. I&l 6, o 1. S...ppllmenlol Relurn o Ao. o 7. 03, 05, Aernai"d.r Return lfa, da", a' dealh prior 'a 12.13,&21 Federal Ella.'. Tal Rtlurn il.quired _ 8, Tatal Numb.. of Sol. D.pa.lt Ba... IRECTED TOi.'": '.,~{!'l1'.'~,::r-~~,' ; ,'-:'"; ", COM,lIn MAllIN(i AOOIU$ D. KODAK, ES UIRE KNUPP & KOD~K. P.C. 407 N. FRONT ST., PO BOX 11848 , 1. R.a' Ella,. ISch.dul. AI 2. 5'0'" and aaod, (Schedule B) 3. Cia..ly Held S,odJPonnenhip Inl.r..t IS,hedul. CI A. Martgog.. end Na". R.cei.ebl. (Sch.dule D) 5. Cash. SOI'lIr Oepalil. & Mi,cellaneous P.'lonal Propvr1y (Sch.dul. E) 6, Join'ly Owoed PraperlY (Sch.dul. FI 7. T,anole" (Schedul. G) ISch.dul. LI 8. TOlal a'DU Au.,. (totallino. 1.7] 9. fun oral Exponu., Admini,troJi"e Cosh. Mi,celloneolll Exp.n..' (Schedul. HI 10. DGblS. Monga(!e liabiliriOl. L:on, (Sehodulo I) 1" T.'al O.dudia" Italol Lio.. 9 & 101 12. Ne' Valu. of Euol. (lino 8 minus line 11) 13, Che.itabl. aod Ga.eromeolal aeque," {Sch.dule JI lA, Net Valu. Subj.d 10 Ta.ILio. 12 mioUlll.. 131 15, SpaUlal T.aollo" 110. dal.. af doa,h ah.. />.3D,9AI . Su InltNC'tionl for Applicable PorconlQ9Q on Ro.,eme Sid., (Iodud. .al... 'ram Sch.dul. K ar Sch.dul. M,I 16. Amoutu of Lino 1.1 tozoblo of 6% rolo IIndud. .o'u.. '.am Sch.du'o K or s,h.dul. M.I 17. Amount of line'" laaable 01 15% ralo (Include .,alulIl fram Sdledule I( or Schodulo M.l 18. Priflcjpal lax duo (Add :0" frClm linos 15, 16 and 17.) 19. Cr"diu SpCl10lsal Povorty Crodir Prior Paymonl' ~ (1) (21 (3) (A) 151 101 (71 268.333.33 2G,215.53 95,525.90 6,922.82 (91 (101 29,970.44 8.439.03 (B) 396.997.58 (I~) (16) 358,588.11 (17) (Il) 38,409.47 (121 358 , 588.11 (131 lA 358 , 588.11 x._= " ,06 a 21.515.29 " ,15 : (18) InloPol1 Oi!counl ... (19) (2DJ Cht(~ here- If you Of. ,cquutlfl9 a ,tf".,d 0' 'tau, o.,urpoymunt. 21,515.29 (21) 121AJ (21a) DEC 03 '96 03:37PM KNUPP & KODAK PC P.5 Act #48 of 1994 provldos for the reduction of the tax ratue Imposod on tho net voluo of transfers to or for tho use of tho spouse. The rates as pre.cribed by tho statuto will be: . 3% (.03) will be applicable far eslatos of docodent. dying an or after 7/1/94 and before 1/1/96 . 2% (.02) will ,be appllcablo for aslate. of decedonts dying on or aftor 111/96'and before 1/1/97 . 1 % (.01) will bo oppllcablo for estalos of dllcedenls dying on or after 1/1/97 and before 1/1/9,8 . Spousal Iranslorl occurring on or after 1/1198 will bo oxempt from inhoritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY,PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent moko 0 transfer and: Q, retain tho use or incamo of tho property transforrod, ....................................................... b. retain the right to designate who shall use Ihe property transforred or ill income; ............... . ., I c. .fotaln Q reversionary In orost; or 1...................................................11....................,........ . . d. recoivo tho promise for lifa of aither payments. banonl. or caro~ ....................................,.. '2. If death occurrod an or before December 12, 1982, did docodenl wilhin two yeors precodlng. death transfer praporty. without receiving odequate consideration' If death occurred after Decomber ,12, 1982, did docedenllransfor properly within ono yoar of death without receiving cdequato ,consideration' .. II ..... II......... ~'" ."........... ......... ..... .........,..... "" ........" to 01..... I... ........... " . . x 3. Did decedent awn an 'in trust for', bank account at his or hor death'..............,....................... X . IF THE ANSWER ,TO ANY OF THE ABOVE QUESTIONS IS YES,' YOU MUST COMPLETE SCHEDULE G AND FILE ITAS PART OF THE RETURN. DEC 03 '96 03:37PM KNUPP & KODAK PC P.6 IIV..,02 IX. 112"$1 ~ COMMONWIAllH 0' ,INNSYLVANIA INHllUTAhCE TAl UTUkN RUIDENT DECEDINT ISTATE Of SCHEDULE A REAL ESTATE FILE NUM8ER BLICHASZ, XAVERIA M. 21-1996-307 (P'op'rT~~~hh Right 0' Svrvlvonhlp must b. dl"l.lld on S.hedul. FI AU..ol..ta'. shovld be ..porl.d a,'.l, ma.ko! valv. whIsh" d.llned .. tho price a' will;' p..p.rty would be exchanged be""..n a willIng bvyor .nd a willing ..II.., neUh.. being compeUed to bv .r soli, both ha.ln roasanabl. knowlodge 0' th. ..Ie.onl 'ad.. ITEM NUMBER DESCRIPTION 1. 50 MATT!lEWS AVENUE, NEW BRITAIN PA VALUE AT DATE OF DEATH $135.000.00 2. FOLLY AND COUNTY LINE ROADS, WARRINGTON TOWNSHIP, BUCKS COUNTY, 1/3 INTEREST 133.333.33 ,rOTAl (...Iso eM.. on lino 1. R....Hvl.ri.n! 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N I.C> _ en _ 1"-1,.., CO ..., N 1.0 CPt,.... ,,"' ,,.. N tfl 0 0 lD 'lP .,.,... N ~ U) U) /11 /11 0 m I;) 0 m aa .".. .. N U).... U),N m LD 0 "".... .. en, /lI"l ." .,. lI"l ..... _ r"I I") ~ ." U.I ,.., ~ ... ~ cz:I 0 "'" If'1 0 N N lI"l ~ en r'I 0 ..., .,.'~ 0 CD ... 01'" '" '" 00 ...,NN...NlI"l...NOw.m~_~~lI"l~OCOM~lDm N~~""~~cz:I ,(7\ cn 8 8 8 _ N N l"'lI ..,. .. lI"l lf1 ~ "" \P l,D = m ~ = CD"''' M ., . ..... lI"l fI') M tf) ... .... N 100____....____..._..............._..._....lI"l~lI"l~"'..,..,..,.,,~~~oo..,. N NIN N N N N N N N N NIN N N N N tv N N N N U) tfl \D ID ID l.D (D l.D ID .... _ _ .... ... ... -' ~ -oJ...J ...J -' ...J ~ -J ...J ~ ...J'...J...J -J .;.J -J.;.J -J...J -J -J ~ a:,~ X :at: X )t')t' )t' )t' X X CI: =1= ....,...,..,~~CIOm=m~mCDCDm~~~~~~~tflOOOOOOOOOO__N~~ ~llli~~~!~~,...~~~i~~~~,...~i~~~~1~1 ~~~.%~%~ "l ~ il= 13,.!.': ~~:>:"'.i. 8:l: 0... ~ il il ~ o:::.!.':.!.':... <1f "i ~I~ 8 0 ~ ~ c ~ ~ n o ,,; l;l ,,; .. .. 8: - ... N ... - - .. '" ,,; ::t '" ... .. '" '" <> '" '" N .. .. ;;; '" q - N .. ..; ~ .. ~ '" ,,; .. ... ...: ;; .. '" oj <; oj ;;; ... '0 .., ~ '" ft .. N '" ... N "l '" '" ... I I i ... "" '" ",' ;; : I , , N ~ . '!i iii , ~ -ll u Ii ~ .. .. ... . .. = ~ e- ~ Jd ~~ao~ s ddnN~ Wdtp'E0 95, E0 J3a DEC 03 '96 03'42PM KNUPP & KODAK PC P.12 ....U......,"".~ COMMONWrAU'H 0' "frrCHsnVANIA ,NHllllANCllAllllTU'N UlIDINT DICEDENT SCHEDULE F JOINTLY.OWNED PROPERTY ESTATI OP BLICHASZ, XAVERIA M. j FILE N~~~Ef996-307 Joln'''."n'(.). NAME ADDRESS A. MARYANN BLICHASZPURCELL106 CEDAR LANE EW BRITTAIN PA 18901 RELATIONSHIP TO DECEDENT DAUGHTER B. CHARLES S. BLICHASZ B. 652 DEER ROAD BOILING SPRINGS PA 17001 SON C. JO'ntly-aWMd praptny' 1TEMU LEnER DATI FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET '" INT. DECEDENT'S INTEREST TlNANT JOINT 1. A 11/74 CORESTATES CHECKI!,;G ACCT. 0301131298 1,554.39 50% 777.20 2. A&B SCH~IAB JOINT ACCOUNT 18,623.07 33% 6,145.62 TOTAL (Ah. ..ltr .n IIn. 6. R.,.~ilul.li.nl S 6,922.82 {II mert 'pace i. needad III.ort addj,jor.a' .heeh of .om' siz.} DEC 03 '96 03:42PM KNUPP & KODAK PC P.13 I!V.\lID!" 1''''1 ~ CCMMCNWfAUH Of nNNlnV,A,HIA 'NHIIITAN&:' 'AX U1U.,. UIID'Nf DICIDINt SCHEDULE G TRANSFERS PLfASf PRINT OR TYPE - fiLE NUMBER ISTATiOr BtICHASZ, XAVERIA M. 21-1996-307 THIS SCHEDULE MUST BE COMPLETED AND PILED IfTHUNSWIRTO ANY OPTHE QUESTIONS ON THE REVERSE SIDE O~THE COVER SHEETlS YES, ITEM DUCRIPIION 01 PROpeRlY TOTAL VALUE I D!~D, gf~Lfc~~t~V.~ NUMIIR ,,,cllId,fIla,,,. 01 ,h,',a,,,It,... tile., ,.taftollftup 10 d~d.,..,. dOl. olltOI'lIN,. EXCLUSION 0' ,usn I INtEREST 1. FIRST UNION NATIONAL l/t/f CHARLES S. ACCT. 2278260786 BANK, CD Bt.ICHASZ. I 1100% I , i o 1.145.61 1 1.145. TOTAL (Alto _nlfl' an Ii". 7. Recapillllcllion) I 5 0" 00 '" ".Ort 'pac. iI n.ad.d, infO" "JcMio"all.!\"" o( lomt 'IU,' DEC 03 '96 03:42PM KNUPP & KODAK PC P.1S ...U'.II.,MIIW tOM-.QHWU,1lH c' """".m.,...NIA ''''toll"...,.CI'''t _trut.. UllOlfrilf ;trefOINf SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Pllo.1 P,lnl 0' Tv I FILE NUMBER ESTATE OF BLICHhSZ, XAVERIA M. ITEM DESCRIPTION AMOUNT NUMBER 1. APOTHECARY RX BILL 276.74 2. ~ECO ELECTIRC BILL 435.45 3. R.V. YOUNG FUELS-FUEL OIL 489.80 4. BELL ATLANTIC-PHONE 168.88 5. BROWNING FERRIS INDUSTRIES-TRASH 102.00 6. CUMBERLAND CROSSING ,221. 27 7. POLYCLINIC 716.00 8. REAL ESTATE TAXES ON 50 MATTHEWS AVENUE PROPERTY 272.44 9. BUCKS CO. WATER & SEWER 220.00 10. CARLISLE HOSPITAL 17.60 11. REAL ESTATE TAXES ON 50 MATTHEWS AVENUE PROPERTY 928.84 12. 8FI-TRASH 51. 00 13. MEDICAL SUPPLIES CO-PAYMENT 539.01 TOTAL lAlla ontor en Ii no 10, Recapitulationl (If mQrv rpccr i, net!c/t!cJ, inJrrl oddi,,'o(lol,neers of Jame siu.' S 8,439.03 ":6 D:: 44F~1 ,..:.Lr:r- 'J -.. -, ,.....-........." ... P,l'3 .. .... .''":'.. I o , , , J. ~o inve~t ~n ~ny ?rO~Q=ti without rQ~:=ic:~on to l~~~l 1nvcJt~Q~t3: I i ~nno: :h3t :~tle ~ha:l ,"as on d~liverl; , , I ., '~I of ci::1e, any propa::"t1: o i I 'with or wi:hout security, :0 exohange 0: ,3:tition ,ro,a::1 3nd co 8:::VC cpt::ona :0: J.11~:) a:;' c:cch~ngo:) i I i I and to oor:~ac. or ,Idda" 3ny p:oparty; I G, 1'0 co"'prod.. claim.; H. To make di3tri~ut~or.3 in ~~nd, c. To r~6i3tQ= ..curLt~a. in the name 0: a nominee 'n .' ch :J. ':0 rapl1i::. .1::a::,. and improve or lease" for any ?ed d r.. To 9811 ~t ?ub:ic 0: ?riV4CC a4~~ :or e~ah or cradi~ :i'. To bO:::~J ~onoy f=co a~1 ?or~on. inc:udlng my Hxecut r, I , , I I I , , I "'hethe:,.,rinC,i,a1.or ',,,,, . ,.. '. , I ~hall not ba ;ubJec: i ! I ! A:'.':'ICt'Z 5 I di::act that ~l:' 3hara~ and intarc9t3 in my 8stata. i:lco~e,' .,l'hi:ein cho hands of my .~Acuto.r, :0 dt:QC~~Qnt. exocu:ion. sequeatration for a~y debt, cont:30: obligation or liabilit1 of any lagateeor beneficia 7, and shall not ba subject to p:od3e.3s~i8nment, conveyance, 0: ~nti:i'PQ:ion. ,; ARTIe:-3' 7 I dirce: :~nt ~:: :=3~9f~r, inheritance. 12gae7. astatQ and aUec~ss ion taxes. and a:l 0: :~e :.1xeo in the 'nn:ur~thoreof. Whethe: State ur ~Qd.er.1.1J .1nd in:~=o!lt a:ld pcn.11:~Qo t~e:'con, . that 0 :13j' ~eco::e 'due or pa1ablc ~1 I'oa,on of 1::1 dCBt~. ..!:t~r..pec t to t~e pro?c::y eompror.U31na -::; 5:-033 e:J'::1tc for :.1:t ?U=?OCQ..1. '.hetha: at" not o\:.ch pt"oper':'l pa890S under t~i3 wil:'. and including ~oin:ly o~~d ?:opurt; and li~a i~su~anca. 3hnll b~ 'paid out Ot .. j - _>'- .J~ : .:.:1 .'1 ,. ~ .1_ i::: ..." <- to,. -. :110 ?:r1nc1;:H":' u! 'JO,/ :H:d.'-\,;.a:~ut,~.:~. to :hH extent tha.t tnnt'Q 10 ''Jch t'C":'~U.1::' .I.V~&~:.lb~\l, ).1 :.: :;~.::\ :.1:hU ',.Jl4;rl! ..dml.;'l.i3t=.'1tion : i ; ':f,u:hor~::c ":J'I rl:c"!c'.:to:" :~ ".1'} .1:1 n;ch t.3:~c:: .1.:: such tima ot' ti:u:!~ I 'I as he:. -:.:1"1 d~nm ,ldvi.1a~:'~, :ai:llrGl.,nn of \IhLl~thfU' I Rue!). =.:Jx.o...o.~ tI~4 thlnn . ..'O' ..~: .1...., C".~.~rtl ~:; "'.... .I.'.~\". .,.....~..'l. "I'~' "!"'o;'"'~'. ,. . '1';~""lt'" 91: ""OW:~'I!i;.\1';1t..... 1~1l.~~~R:)' "'::'>::,i.~li:(~tr--'l.~t....~.' ,':,,!\ ~ . ~..:. ....'1'=>.0'~:11 ~~UR .~""":f;r.!:\;~:;:...." (:;jh;,.~1"~~",,,~,":~"'...:4~,,';'J'"''''''1''~fI"''~~~''' 1.. ".R\"" , . T '" I"",,, ',' ',' ,~~~~c;:~ 3' .' '-," ,~ \ " \ : ~P?oinc a. Guard~~~3 :or an, ?rop~rt; p.Q3ine hQreundlr to a ~inor. a~d a~; Gr.ar. o! lnJu:or.co procKuds and ot~cr propc:cJ I ~~penjC3 ~i:~QU~ ~?Po~:~~~~cn: 0: :~~ht ot ~a~~bur3c~cnL. wi=~ r@spec: :0 ~h~ch : ~ave 3 ~CWQ= :0 .1.?point a Gua=di~n, t~~ ~a=~nCJ Qf :~C~ ~~nor ...: ni:!~~':1er ?~=cn: 0: such minor! I 0= ~:".O=:I. or ~~~o=: ~s t~Qn liv~;'l.6 : 3p?olnc my oldccts~=vivin~ child I ~G Guardi~n for ~ny prope::1 ,a~:I~~~ h~r~under :0 Juch minor 0: I minors, ~nd 3ny sh3re o! ~n~u=3..c~ ~rocaedd and ot~ct' ?roper:y with I ~esp~c. to wh~eh I hovc a ~ow~r to appoint a Guard1an. Suer. I '.Cu.~=~i~r. ~ho..ll.:~..:L~,~:.t~7 ad:1,~n,~~~~:1t::!"/C p~wer:J.' aiven .hBrp-~~~~~.j~Q.~ I ~I ~xacuCo= ~nd :nH ~ddit~or.~: ~cwcr~ ~it~oue court 'upproval. to il use principe: as wc:: ,,. ineor.:. :0:: :~o ::,.ino~' 0 wRl.::ar.. to i:lVOG1 II in a:ro."! ~O~ 0: property lJithou: ~c!.:\3 l:!.::l:.:~d to 1eBsl inve"t:ncr.c~, :\ I . and to ~c:3i~ 0= S~:: a~:~cl~~ 0: :3ng~bla ~c=sonalt1 or di3t=ibut~ I . I ,I :!lee co ::.u :::inor or ar.; ?orscn :0 :101d fo~ thc :ni:lor, :1 I ! di=~c: that :~e Gua:ci3n for the estat~ 0: ~ minor ,h,ll noc :~ ::c~ui:od :0 cn:.r bond or ouraC7 ~n any Jurisdiction I l:l \m::r::ss :'1;:;::U;O? :. :<'WER!..\ 3L:CllAS:, hereby sce "''I h~nd to t~l3 ~J last ~il: and ~~s:3~nt, e~paBC ~f ~h~ch nas I :Ben 1ni:iol:cc :7 :ta~ on l;;~ :ll,o -z,;:. dol:! 0: rv."......Je.r, \ II 1978, .It JC'llo.3cown. :ar.nsl1'l3ni.1.1 \1 ~,;.. pk.t- , ;(.\',";'._\ JL.:l::lX...; r I i S~~noc, GC01Bd, ?u::l.hod and cccla~ed b., :lAVZ^I~ 3LIC& S:, I :~\C '.1covJ!-na;\ed l'cti t.'lt:-'i.:<, ~.::J .1r~d :0:' ht:t' l.ISt Wl.:l a.nd 'l'c~tament 1 i , . I I i.:J . ,~'.) DEe 03 '96 03:46PM K~JPP ~ KODAK PC CoreSlales ~ln4nCIlII \,;orp CPA and Government Roqyosl Department FC 1.2.10.16 PO Box 6667 Philadelphia PA 19101.e667 2159734619 , Kay 31, 1996 Robert D. Kodak KnUpp & Kodak, P.C. 407 North Front street P.O. Boz 11848 harrisburg, PA 11108-1848 Re: ESTATE OP xaveria Bliohasz DATE or D~ATH: MarCh 4. 1996 Dear Mr. Kodak: P.23 . CoreState! In response to your letter ot Kay 15, 1996, please be advised that decedent held the following accounts with our bank: Account No: 324398001-4398001 CERTIFICATE Stanley A. Blichasz i~~.a:::J1J,icha,sZ 07/08/94 $27,5&3.78 S 686.4ji $28,250.24 Title: Date Opened: Date of Death Balanoe: Acorued Interest: Total: Account NO: 324398001-4821001 CERTIFICATE stanley A. Blichasz 9'.Gil....itl,f'ChS'Sz 10/06/93 Title: Date opened: Date of Death Balance: Accrued Interest: Total: 1099 Interost: $2,538.80 9 3S.0S $2,573.8S 324398001-4821002 CERTIFICATE Stanley A. Blichasz ~era':Bl1a1iaiiz' 11/04/93 $1,1&2.42 " 9 13.01 $1,175.43 324398001-4821005 CERTIPtCATIl stanley A. Dlichasz tJler.a;:Bttchas ~"-::I 03/04/94 $1,640.19 S .59 $1,640.78 $ 52.58 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUR[AU or INDIVIDUAL lAMES INhllH UNCI u. 1l1\l1~t1lN 1II11T. ""0"01 IIAIlll15ftUllG, II' I/t.'8 OhDI HDIICE or INHERITANCE lAM APPRAISEMENT, AllOWANC[ OR DISALLOWANCE or OEDUCTIONS AND ASSESSMENT or TAX 03-17-97 BLl CIlASl 03- 0(, -96 21 96-0307 CUMBERLAND 101 l~-----~_~"n\ R..I \ \_od 70-Y . ,I f'V:J MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT AI.ONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... R"EV: iS4i-~'i - AF-puio'J: 9'ii -i:o"';"f;; t-'o ,: -:; :li tRY f~ :f~ E - i'f.X -jl~,; !;;'-~-'; S E,i it" ~T': -A L'i."OWAtfCf 'oR'-' n_ _.- -. - - - - -. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX XAVERIA M FILE NO. 21 96-0307 ACN 101 If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that inr:luda tt>n tr.t,,) ,f ~,l L r!!t\!rn!: :;::~G!::;Gd tu c'ate. ASSESSIIENT OF TAX: 15. Amount of Line 14 at Spousal rat. 1&. A~ount of line 14 taxable at LinDal/Class A rat. 17. Anount of Line 14 taxable at Collateral/Class 8 rat. 18. Principal Tax Due TAX CREDITS: PAYMENT DATE 12-04-96 ROBERT 0 KODAK ESQ 407 N FRorH ST PO BOX 11848 C HBG P~:'17108 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN ESTATE OF BLlCHASl TAX RETURN WAS: I I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R.al Est.t. (Schedule A) 11) 2. stocks and Bonds (Schedule 8) (2) 3. Closel~ Held stock/Pa~tne~ship Inte~est (Schedule C) (3) 4. Ho~tgages/Hotes Receivable (Schedule 0) (4) 5. Cash/Bank Oeposits/Hisc. Pe~sonal P~ope~ty (Schedule E) (5) b. Jointly Owned P~opedy (Schedule f) l&) 7. T~ansfe~s (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Hortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Het VaJue of Tax Retu~n 13. Ch.~\tl 1./GoY.~nMent.1 aequesls CSchedule JJ 14. Net Val~' of Estate Subject to Tax NOTE: 115) 11&) 1171 RECEIPT NUMBER AAI84918 DISCOUNT 1.1 INTEREST/PEN PAID 1-) ,00 I X I CHANCre SEE 268.333,33 26.215,53 ,00 ,00 95.525,90 6.922,82 1.145,61 10) 29,970,44 8.439,03 (11) I1Z1 1131 114) ,00 X' 00: 359,733,72 X, 06: ,00 x, 15: 1101 AMOUNT PAID 21, 515,29 INTEREST IS CHARGED THROUGH 04-01-97 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ... ~~ ..;1 :~..,.,.,'i.'i'r. 11,'7,::~t<~'I-);, ~~ r'r.:Ht.'"-L t..,.r.'~";'!f'f,.~ "'1\01,. t" ,:1 t/I XAVERIA M DATE ATTACHED 03-17-97 NOTICE NOTE: To insure prop.~ c~8dit to your account, subMit the upp.~ portion of this fo~m with you~ tax paYMent. 398,143,19 3R,40Q 47 359.733.72 .00 359.733,72 ,00 21, 584.03 ,00 21,584,03 21,515.29 68,74 2,00 70,74 M IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, IF TOTAL DUE IS LESS THAN ~I. NO PAYMENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRl, YOU MAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS,) RESERYATION: Eslalas of dacedenls dying on or bafor. O.c.ftb.r IZ, 198Z .. If any fulur. Inl.r.sl In tha .slal. Is transferr.d In poss.nion or .nJoy..nt 10 CI,n. R lcollllt.rllll be"eflcll'l,"I._ o! ~h. ........oJ....~ !!',..'" ~~n "t.piro~lor; of any o.:;tatlil for 11fa or far yaars, Ih. Ca._onweolth h.reby ..pr.ssly ra..rva. the rlghl 10 opprais. ond 1'1..... Iran.f.r Inh.rltanca Ta... at Ih. lawful Cia.. B Icoll"l.ral) rala on any 'ueh fulur. Inl.r.'I. PURPOSE OF HOTlCE: PAYHENT I REFUND (CRI: OBJECTIONS: ADHIN ISTRATlYE CORRECTIONS: DISCOUNT I PENALTY: INTEREST: To fulfill Ih. r.qulr..enls of Section ll~O of Ih. Inherllance and [sial. 'a. Act, Act ZI of Iq9~. lZ P.S. S.cllon 91~0. Delach Ihe lop porllon of thl. Notle. and subolt with your pl'ly..nt to tho Reglsler of Wills prlnled on the r.verse sid.. "Hak. check or 80ney order payable 101 REGISTER OF' MILLS, AGENT A refund of a ta. credit, which was not reque.t.d on Ihe la. Return, .ay be requested by co.plellng an "Application for R.fund of Penn.ylvanla Inherllanca and [.Iale la." (REY'llIl). Appllcallon. ar. avallabl. at Ih. Office of the Reglsler of Wills, any of Ih. Zl Rev.nue DIslrlct Offlc.s, or by calling Ih. ,peclal Z~-hour an.werlng service nu.bers for for.. ordering: In Ponnsylvl'lnla 1-800'l6Z'ZO~O, oulside Pennsylvania and within local HarriSburg araa (1111 781'8094, lODe (117) 11l'ZZ~Z CHearlng lapalred Only). Any party In interost not satisfied with the appralse.enl, allowance or disallowance of deduclions, or a..e..o.nl of la. I Including discount or Inl.restl as ,how~ on Ihis Nollc. .ust obJecl wilhln sl.ty l60J days of r.c.lpl of Ihls Nollce by: "writl.n prol.sl to Ih. PA Deparl.ent of R.venue, Board of Appeals, Dept. ~810Z1, Harrl.burg, PA 171Z8'IOll, OR .'olecllon 10 have the .atl.r d.tor.lnad al audll of Ih. accounl of Ihe porsonal r.pr.sentallv., OR .'app.al to Ihe Orphans' Court. Faclual .rrors dlscoverad on Ihls aSI.s'.ant should be addrassad In ~riling to: PA Deparl.ent of Rev.nue, Buraau of Individual la..s, ATTN: Post Assess.enl R.vl.w Unll, Depl. Z80601, H.rrlsburg, PA 17118'0601 Phona (117) 181-6~05. S.. p.g. 5 of tho book lot "Inslructlons for Inherllanc. la. Return for a Re.ld.nt Daced.nt" IREY'I~OI) for an .wpl.n.lion of ad.lnlstrallvely correct.bl. .rrors. If any la. due Is paid wllhln thrne (3) calend.r .onlhs afler tho dac.dent's daalh, a flv. parcent (~%) discount of Ihe la. p.ld Is allowed. Th. I~:C UlI ...n..1)' nun-",o"'U.:lp.,tI.:m rc~::1t... !s c:~rute:! f:" t..o tolal of Itt. lu and Inler.sl a,u..ad, and not p.id before January 18, 1996, tha flrsl d.y afl.r Ihe .nd 0' Iha lall a.nosly parlod. lhl. non-participation p.n.lly Is appealable In Ih. sa.e ..nner and In Ih. Ih. sa.. tl.e parlod as you would app.al Ih. la. and Inl.r..t Ihat has b.en alsassed a, Indicated on Ihls notica. Inl.ra,t Is charged beginning wllh flrsl day of delinquency, or nine (9) lonlhs and on. (1) day fro. Ih. date of dealh, to Ih. date of pay..nl. Ta.., which bacaae dellnqu.nl before J.nuary I, 198Z bear Inleresl al Iha rale of .111 (6%) perc.nl per annul calculal.d al a d.lly ral. of .000164. All I.... which beca.e delinquent on and aftor January I, 198Z will b.ar Int.r.st at a rate whiCh will vl'lry fro. cal.ndar year to cal.ndar ye.r wllh Ihat rata announced by Ihe PA Depart.enl of Rav.nue. lhe appllcabl. Int.rest ralas for 198Z Ihrough 1997 ar.: ~ Intornl Rat. Dllih Inlar.sl factor !!!!' Inlorest Allt. DAily Inlarnt Fllclor 198Z ZO% .OOO~48 1981 " .000Z41 1983 16% .0DO~38 1988-1991 11% .000301 1984 11% .000301 199Z .~ .OOOZ~7 198~ U% .0003~6 lq93-199~ 7% .000191 19116 10% .000174 lq9~.1997 .~ .000l~7 "Inl.rut Is calculahd as follows: INTEREST = BALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY INTEREST rACTOR '-Any Notlca issued aft.r Iha ta. b.co.es dallnquenl will reflecl an Inler.sl calculallon to flfleen (15) day. beyOnd Ihe dala of Ihe assas'.'nl. If pay.ent Is .ad. afler Ih. Inter.sl co.pulallon dale shown on tha Notlce, additional Inl.resl .usl ba calculalad. . ......_-... - , ,__: 9(, - /.3' ('/ * COMMONWEALTH OF PENNSyLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT BUREAU OF INDIVIDUAL TARES IHttlRIIAHC[ lAIC DIVISION D(Pl. lao~Ol HARRISBURC, PI 111:'8-0.01 In...'' II "' 111"1 ROBERT D KODAK 407 N FRONT ST PO BOX 11848 HBG ESQ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTy ACN 05-05-97 BLlCIlASZ 03-04-96 21 96-0307 CUMBERLAND 101 XAVERIA M PA 17108 [' Anount Renltt.d -l MAKE CHECK PAyABLE AND REMIT PAyMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT 1l0USE CARLISLE. PA 17013 HOTE1 To insure proper credit to your account, lubnlt the upper portion of this forM with your tax paynent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... iiE"v:il.iii'EX-AFi>--io3":97ym---iiiiii-iiiHEiiiTANCE'-iAX'STA'TEiiE"tii-OF'AC-ciiiJiif""iiliiiu_m_m--m_m_- ESTATE OF BLlCHASZ XAVERIA M FILE ND.21 96-0307 ACN 101 DATE 05-05-97 THIS STATEHENT IS PROVIDED TD ADVISE DF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE, SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAR DUE. APPLICATION DF ALL PAYHENTS. THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE, DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 03-10-97 PRINCIPAL TAX DUE: 21.584.03 PAyMENTS (TAX CREDITS): PAyMENT DATE 12-04-96 04-08-97 RECEIPT NUMBER AA184918 AA185369 DISCOUNT (+) INTEREST/PEN PAID (-) .00 2.12- 21.515.29 70.86 AMOUNT PAID TOTAL TAX CREDIT 21, 584,03 ,00 ,00 BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATIDN OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED, IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FDR INSTRUCTIDNS, 0G t: .. " PAYPCENTI D.tach thl top portion of thl. Hotlc. and .Ub.lt with your pay..nt .ad. paYabl1 to the na.. and ad~~' prlnt.d on the r.v.r.. sid.. , If RESIDC"T DECEDENT .ak. ch.ck or .on.y ord.r payable tal If NON'RESIDENT DCCEOENT .ak. chack or .on.y ard.r payable REGISTER OF WILLS, AGENT. . 1,1 tOl COHHONWEALTH OF PENHSVLVANIlr. REFUND eCAI: A r.fund of a ta. cr.dlt, which was not r.qulsted on the Ta. R.turn, .ay b. rlqu.stld by cOAPI.tlng an "Application for R.fund of P.nnsYlvanla Inherltanc. and Estat. Ta." (REV-IlI]I. Application. are available at the o'flc. 0' thl Ragl.t.r of Wills, any of thl Z] Rlv~ DI.trlct OffiCI. or fro. thl Oepart.entt. Zft-hour an.werlno .ervlca nu.b.r. for for.. ordarlngl In Pann,Ylvanla 1-800-16Z-Z050, out.lda Pann.ylvanla and within 10c.1 Harrl.burg ar.a (1111 181-8094, TOOl (1111 llZ-ZZSZ (H.arlng Iapalred only). REPLY TOI Qu..tlon. r.gardlng error. contained on thl. notlc. .hoUld bl addr....d tal PA Dep.rtaant of RIVanu., Bur.au 0' Indlvldu.1 T...., ATTN: Post A......lnt R.vl.w unit, Dapt. Z80601, Harrl.burg, PA 17128-0601, phon. (717J 787-6sa5. DISCOUNT: I' any ta. due I. paid within thr.. ell cal.nd.r ~th. .ft.r the dec.dantts death. a flv. p.rc.nt (SX) dl.count of thl t.. paId I. allowld. PENALTY: Tho 15% ta. aana.ty non-p.rtlclp.tlon pen.lty I. caaputed on the total of the t.. and Int.r..t ..se..ed, and not paid b.for. Janu.ry 18, 1996, the 'Ir.t d.y aft.r the end of the ta. .~e.ty p.rlod. INTEREST: Inter..t I. ch.rged big Inning with flr.t day of d.llnquency, or nln. (9) aonth. and on. (I) d.y frol the d.t. of death, to the d.tl of pay..nt. ,.... which bec... dlllnqu.nt b.for. January 1, 198Z b..r Int.r..t at the rat. of .Ix (6%1 p.rc.nt per .~ c.lculatad at a d.lly rat. of .0Dal64. All ta.e. which b.c... delinquent on end aft.r Janu.ry I, 1982 will bl.r Intlre.t .t a ratl which will v.ry fro. calendar y..r to calend.r year with that r.t. announc.d by the PA Dep.rt..nt of Ravenu.. Thl appllc.ble Interl.t rat.. for 1982 through 1997 ar.: V.ar Inter..t R.te Dally Int.r..t Factor Ve.r Inter..t Rate Dally Inter..t Factor 1981 lO;( .aaaS48 1981 .~ .aaOl47 1983 l.~ .aaa438 1981-1991 11;( .aOO301 1984 11;( .000101 1992 .~ .oaOZ41 1985 13~ .aOO356 199]-1994 n .aOO192 1986 10;( .DaOZ14 1995-1997 OX .000Z4l ulnter..t I. calculated .. follow.: INTEREST = BALANCE OF TAX UNPAID X NUNBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Not Ie. I..u.d .ft.r the t.x b.co", d.llnquent will r.fl.ct en Int.r..t c.lculltlon to flft.an (151 day. b.yand the d.t. of the ....s...nt. If pay.ant Is a.dl aft.r the Int.r.st coaputatlon d.t. shown on the Notlc., addltlon.1 Int.r..t au.t b. c.lculat.d. (";.l-, - ...-. - -....-. ,-".. .'- LAW OffiCES OF KNUPP & KODAK P.C. CAMERON MANSION 0107 NORTIl FRONT STREET P,O, BOX 11848 HARRISDURG. PA 17108.1848 d Ru"c"- ... ,,\. ...~:: 13 -. .:., '97 H?I(-" ; , 3 G!~~ CUI ., t :, ~', . , , " '1':- . .~...~'-"- I c 1",111,'1111"".,11,,11,1,,1,1 .~ ~ --. ....... __~___ _ 0-11 ,,1""" ,...' -- ..~;..,~_I .);--i':i\,i.".",,-t"- - . . 1,..11..11,..11...11,1,1....1,11,1..1 . -t(, ,~:-.. ,,' :',1- ~ t ' ,\ .. ,I" fl' "t .,..j :' ,.\' { ", . )- .. ~ \ 'h. . ~ 4 .1 ~ .r.' ~ . ., . . \ ~'., .(.. , '., ,..,' " oi' ,..i) -~---' . .-.. ... 11 ( " / STATUS REPOR'r UNDER RULE 6. 12 Name of Decedent: Xave~ia M. Blichasz Date of Death: 3/4/96 W ill No. 1996-00307 Adm in, No .21-1996-0307 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate l.S complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 12/30/1998 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X . b. The sepal-ate OqJhans' ("urt No. (if anYl for the personal representative's account is: c. Did t,he personal representative state an account informally to the parties in interest? Yes No X d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may'-be filed with the Cerk of the Orphans' Court and may be at~a~~ to t~~..>>~ Date: t.jfi}/f.f ' ,,-f)a{.(.&'~___ 7 I Signature , I I , Robert D. Kodak Name (Please type or print) P.O. Box 11848 , Har~isbu~g, P~ 17108 Address L2l7) 238-7151 Tel. No, Capacity: Personal Representative X Counsel for personal l-epresentat i ve (MAH: rmfl AM3)